EDITORIALSodium--glucose co-transporter-2 inhibitors for patients with diabetic and nondiabetic chronic kidney disease: a new era has already begunSarafidis, Pantelisa; Ortiz, Albertob; Ferro, Charles J.c; Halimi, Jean-Micheld; Kreutz, Reinholde; Mallamaci, Francescaf; Mancia, Giuseppeg; Wanner, Christophh; for the ‘Hypertension and the Kidney’ working group of the European Society of Hypertension (ESH) and the ‘European Renal and Cardiovascular Medicine’ (EURECA-m) working group of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Author Information aDepartment of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Greece bIIS-Fundacion Jimenez Diaz, School of Medicine, University Autonoma of Madrid, FRIAT and REDINREN, Madrid, Spain cDepartment of Renal Medicine, University Hospitals Birmingham, Edgbaston, Birmingham, UK dService de Nephrologie-HTA, dialyses, transplantation rénale, CHRU de Tours-Hospital Bretonneau, Tours, France eInstitute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany fCNR-Institute of Clinical Physiology, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria gUniversità Milano-Bicocca, Milan and Policlinico di Monza, Monza, Italy hDivision of Nephrology, Wuerzburg University Clinic, Würzburg, Germany Correspondence to Pantelis Sarafidis, MD, MSc, PhD, Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, GR54642 Thessaloniki, Greece. Tel: +30 2313 312930; fax: +30 2313 312930; e-mail: [email protected] Received 3 November, 2020 Accepted 7 December, 2020 Journal of Hypertension: June 2021 - Volume 39 - Issue 6 - p 1090-1097 doi: 10.1097/HJH.0000000000002776 Buy Metrics Abstract Chronic kidney disease (CKD) is a major issue of public health. Hypertension control and use of renin--angiotensin system (RAS) blockers are the cornerstones of treatment for CKD of any cause. However, even under optimal RAS blockade, many individuals will progress towards more advanced CKD. Within the past few years, evidence from cardiovascular outcome trials with sodium--glucose co-transporter-2 (SGLT-2) inhibitors clearly suggested that these agents substantially delay CKD progression in patients with diabetes mellitus on top of standard-of-care treatment. The Canagliflozin-and-Renal-Events-in-Diabetes-with-Established-Nephropathy-Clinical-Evaluation (CREDENCE) study, showed that canagliflozin substantially reduced the risk of doubling of SCr, end-stage kidney disease (ESKD), or death from renal or cardiovascular causes in 4401 patients with diabetic CKD compared with placebo (hazard ratio 0.70; 95% CI 0.59–0.82). Recently, the Study-to-Evaluate-the-Effect-of-Dapagliflozin-on-Renal-Outcomes-and-Cardiovascular-Mortality-in-Patients-With-Chronic-Kidney-Disease (DAPA-CKD), including 2510 patients with diabetic and 1803 with nondiabetic CKD, also showed an impressive reduction in the risk of ≥50% decline in eGFR, ESKD, or death from renal or cardiovascular causes (HR 0.61; 95% CI 0.51–0.72). The benefit was similar for patients with diabetic and nondiabetic CKD, including patients with glomerulonephritides. Following this conclusive evidence, relevant guidelines should accommodate their recommendations to implement treatment with SGLT-2 inhibitors for patients with diabetic and nondiabetic CKD. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.